Baptiste S J, van den Boogaard W, Letoquart J-P, NDong J-G, Jonacé G, Télémaque L-F
Centre Traumatologie Tabarre, Médecins Sans Frontières (MSF), Port-au-Prince, Haïti.
Département Médicale, Unité recherche opérationnel (LuxOR), MSF, Luxembourg.
Public Health Action. 2023 Aug 1;13(2 Suppl 1):1-6. doi: 10.5588/pha.23.0008.
Abdominal trauma (AT) appears to be frequent in Haiti, which is confronted with recurrent socio-political violence.
To study patients admitted for AT to the Médecins Sans Frontières (MSF) Tabarre trauma centre (Port-au-Prince), and the circumstances of occurrence.
This was a cross-sectional study with retrospective data from January 2020 to December 2021.
Of 3,211 patients admitted for trauma, 541 (17.3%) had an AT, of which 500 (91.4%) were related to sociopolitical events. Their median age was 30 years (interquartile range [IQR] 23-38); 429 (85.8%) were male. A gunshot wound was noted in 371 (74.2%). The median distance from the scene of violence to the hospital was 11 km (IQR 7-15); however, 9 (1.8%) came within 1 hour of the trauma; transfusion was not done or insufficient in 169 (33.8%). An adverse outcome (death, referral, discharge against medical advice) was noted in 57 (11.4%), with 8.0% of deaths. Political instability was the main cause of violence. An adverse outcome was associated with inadequate transfusion (hazard ratio [HR] 2.4, 95% CI 1.4-4.3; = 0.006) or gunshot wound (HR 2.4, 95% CI 1.1-5.2; = 0.002).
Firearm injuries were common during the period of sociopolitical events 2020-2021. The lack of blood products had a negative impact on patient outcomes. Safety measures and blood collection still need to be maintained and strengthened.
在面临反复社会政治暴力的海地,腹部创伤(AT)似乎很常见。
研究入住无国界医生组织(MSF)塔巴雷创伤中心(太子港)的腹部创伤患者及其发生情况。
这是一项横断面研究,采用2020年1月至2021年12月的回顾性数据。
在3211例因创伤入院的患者中,541例(17.3%)患有腹部创伤,其中500例(91.4%)与社会政治事件有关。他们的中位年龄为30岁(四分位间距[IQR]23 - 38);429例(85.8%)为男性。371例(74.2%)有枪伤记录。从暴力现场到医院的中位距离为11公里(IQR 7 - 15);然而,9例(1.8%)在创伤后1小时内到达;169例(33.8%)未进行输血或输血不足。57例(11.4%)出现不良结局(死亡、转诊、违反医嘱出院),死亡率为8.0%。政治不稳定是暴力的主要原因。不良结局与输血不足(风险比[HR]2.4,95%置信区间1.4 - 4.3;P = 0.006)或枪伤(HR 2.4,95%置信区间1.1 - 5.2;P = 0.002)相关。
在2020 - 2021年社会政治事件期间,火器伤很常见。血液制品的短缺对患者结局有负面影响。仍需维持和加强安全措施及血液采集。